Article
Wide-Awake versus General Anesthesia Results in Patients with Dupuytren’s Disease Surgery: Preliminary Results
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Authors
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Zeynep Tuna
- Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
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Ali Nazmican Güröz
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Orthopaedics and Traumatology, Ankara, Turkey
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Egemen Ayhan
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Orthopaedics and Traumatology - Hand Surgery, Ankara, Turkey
| Published: | February 6, 2020 |
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Outline
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Objectives/Interrogation: Wide-awake local anesthesia with no tourniquet (WALANT) has an increasing popularity in Dupuytren's disease surgery as it eliminates adverse effects of general anesthesia and the need for hospitalization. Moreover, in Dupuytren's surgery, controlling active movement during the surgery is the foremost advantage of WALANT besides providing a bloodless area for the fine surgical intervention. For this reason, we hypothesized that the WALANT technique would improve the clinical outcomes in patients that were operated for Dupuytren's contracture. Therefore, the aim of this study was to present our preliminary results in patients who underwent open partial fasciectomy under WALANT and compare their results with those that had GA.
Methods: Nineteen patients were called up who were operated between January 2017 - June 2018 and 12 of them were reached. One patient was excluded due to cardiac surgery during follow-up. Five patients were operated under WALANT and 6 of them had GA. Range of total active flexion motion and residual extension deficit were measured and pain, satisfaction level, post-operative analgesic use, follow-up period since surgery and any recurrence were recorded. Results of the patients in the WALANT and GA groups were compared.
Results and Conclusions: The mean age of the patients were 60 years in GA and 67 years in WALANT group. Patients were operated on their 4th or 5th digits. Mean follow-up was 13 months in the GA group and 6 months in the WALANT group (p>0.05). Total range of active flexion was 264±13° in the WALANT group and 252±32° in the GA group. Moreover, no residual extension deficit was seen in the WALANT group while it was 8±11° in the GA group. However, the differences were not statistically significant. Pain level, post-operative analgesic use and patient satisfaction were similar across the groups.
In this preliminary study, although not being statistically significant, WALANT technique seems to provide improvements in the total active motion and residual extension deficit in patients who underwent surgery for Dupuytren's contracture. However, as a limitation, we have to declare that present extension deficit in GA group may result from mild recurrence due to longer follow-up period. Studies with large samples and long-term follow-up will provide evidence for clinical outcomes and especially recurrence rates.
